HomeMy WebLinkAboutStreet Cut Permits 387 Foster Street (3) 1600062 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
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DATE: 05/09/2016
GIS ID:33600387 n �
FEE: 25.00
MUMS APPLICATION# 201600578 XPIRATION DATE: 05/09/20I7.
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APPLICAN s ,
�._ LOCATION
NAME: R&D UTILITY COl� RUGTIO tI VC ADDRESS 7`F, TER STREET
ADDRESS: 1603 MONROE TPK �E` G ,yVIN E&MARGARET C
MONROE,CT 0646of t��I R �05'TER STREET
PHONE `" $OUTHWINDSOR CT 06074
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WORK DESCRIPTION: RE�O�iT�Ei ItERALORC�NIR4 CQ ICAg�IONS
IN F'R( VTP8TOSTR4415TI3 (JCT3�IIILRIVE
APPLICANT AGREES TO FURNISH TH ?+O10
N�GaFOII3SI'IAVIp1IT�q $OND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR AMEN $IN � YHEt �f3'WF�JI 'IVIAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND TAT t�T'IsLIGMT,IS, FAI IAIZIIIL L ASIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE O SQT7'TH' I'NDS It S TR ET CUT PERMIT MANUAL.
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ISSUED BY DA`T Ih `PELTED INSPECTED BY
5/10/201611:13AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTIQ REPORT
PERMIT NO.: O CONTRACTOR:
LOCATION: "7 -a, <S 0 141
TYPE OF WORK: /W&Ag
DATE INSP NEEDED: DATE INSP: if,
INSPECTED BY: ?3 i7
WORK IN
PROGRESS: C
r
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑YES ❑ NO
AS-BUILT:
INPUT:
S/motloy/forms 2014 Town of South Windsor INPSEMON REPORT 14
APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No.
TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT 06074 FEE $25.00
Name of Firm O 1J Phone No.
Address of Firm 1603n ro J P'r-p— M6r)q& Q17 Zip Code 4%q"
Gec Ion o proposed wor :SS-
Describe fully nature of permit requested Re rocw t-L Foe- Frovv+t-,e Cpr� n•i
Starting date Call Before You Dig No� �
PLEASE NOTE: THE DEPOSfT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT, INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS, THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: ❑ No Pavement, Curb or Sidewalk Cut ly Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut
❑ Existing Driveway, No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: ❑ Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic
Show sketch of proposed work or furnish Indicate North This section to be filled out by Town
two copies of separate drawi g
No. cuts
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Est. Patch Size(s). y 14 _sf
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Est. Pvt. Thickness in.
Est. Patch Unit Price$ '2C ;sf
Est. Patch Cost$ _ CIT"
Est. Curb Replacement fn61&cw_ft
Est. Curb Unit Price$ !ft
_ Est. Curb Cost$
Est.Sidewalk Replacement (A uI�Af
Est. Sidewalk Unit Price$ Isf
Est. Sidewalk Cost$ _
Est.Traffic Hours hr
Est, Traffic Unit Cost$ Ihr
S Est.Traffic Control$
Amt.of Deposit$
DRIVEWAYS must be 3ft or more from the property line per Total Due$ fi 3OK
section 2.17 of the zoning regulations
{ } Cash M Check# 7-069 2
Applicant is responsible for contacting the Police Dept. and C.B.Y.D
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES Paid By
I AGREE TO FURNISH TO THE TOWN OF SOUTH WIN116OR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE THE TOWN OF SOUTH
WINDSOR FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT A14D
THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH
WINDSOR`S STR UT PERMIT MINUAL.
Signed: Print Name �t-�-' "' 6(\n t) Date: